Dr. Bhagirath Singh
Scientific Director,
CIHR Institute of Infection and Immunity

December 1, 2009

This past year has been one of mixed emotions with ups and downs in the search for an effective vaccine to eradicate HIV, the virus that causes AIDS.

After the disbanding of the 2007 STEP trial of the Merck HIV-1 vaccine, researchers around the world awaited the outcome of the Thai Phase III Prime Boost Trial.  Released in September, the results of the 16,000-person trial - the largest ever human study of an HIV vaccine - were mixed. While the combination of two vaccines did produce only a modest reduction in infection risk, the trial demonstrated for the first time that it is possible to develop a vaccine to protect people against HIV.

I see the Thailand study as a stepping stone to developing new vaccines. It gives us significant hope. This trial has taught us that it is possible to come up with a vaccine that may prevent or slow down the spread of HIV. But we have to rethink our approach. We have to come up with new ways to defeat this deadly disease. This, after all, is what scientific investigation is all about: finding new ways, new approaches.  I truly believe that innovative research will ultimately lead to the eradication of HIV/AIDS.

Through the Canadian HIV Vaccine Initiative, a partnership with the Bill and Melinda Gates Foundation, several research groups in Canada are currently focusing on vaccine discovery. We will continue to encourage them to carry their work forward with their international partners. This is important because it will not be one researcher or one medical centre or even one country that develops the HIV vaccine; it will come from a coordinated global effort. We also support the direction set by the Global HIV Vaccine Enterprise, led by former CIHR President Dr. Alan Bernstein, in the development of new vaccines. 

However, while we must think globally, we must also act locally. In this regard, CIHR's HIV/AIDS Community-Based Research Program has become a model for enabling communities to play a central role in health research. Whether it is Aboriginal groups or people living in urban centres, communities dealing with HIV are providing a real-life, real-time window on how to inhibit the spread of the disease and make sure that people get the help they need. Initiatives like the CIHR co-funded Positive Spaces, Healthy Places project - the first longitudinal community-based study of its kind in Canada - are leading to healthier housing conditions and better supports for people living with HIV. This is what patient-oriented research is all about: engaging a community and empowering its people to take charge in the prevention and treatment of disease.

Since the discovery of the HIV virus more than 25 years ago, we have made major advances in controlling AIDS. For many, the development of anti-retroviral therapies has meant that what was once a death sentence is now a chronic condition. While those breakthroughs are to be applauded, the drug regimens that they have produced are costly and often beyond the reach of people in developing countries. And chronic disease remains a huge burden in terms of its impact on peoples' lives and health care systems. However, many initiatives undertaken by philanthropists, agencies and government have made a difference in helping people to have access to these drugs.

HIV/AIDS remains a global epidemic. According to the Joint United Nations Programme on HIV/AIDS, 33 million people were living with HIV in 2007 and 2 million people died from AIDS. Across the world, there are 2.7 million new HIV infections each year, with almost 3,000 new cases in Canada.

World AIDS Day provides the opportunity to look back with considerable pride on the advances we have made in preventing and treating HIV/AIDS - progress that would not have been possible without the active participation of patients and their families and people who have rallied behind their cause. Additionally, it gives us pause to think about how far we still need to go. It recharges our resolve to explore new pathways in the journey to a vaccine.